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Information for plan sponsors, administrators and advisors

COVID 19

Last updated on: 2022-04-08

Services maintained, but prioritized

All your claims will be processed as quickly as possible by our employees working remotely.

A general information page related to COVID 19 is available and updated on a continuous basis. We are monitoring the situation closely so that we may quickly adapt and continue to serve through this difficult period.

New – Access to psychological assistance

Beneva now offers all its insureds access to psychological assistance in the form of 3 hours of free telephone consultations. You can contact the service 24/7 at 1 855 874-8558.

Make sure you have your contract or certificate number on hand.

Reduced work hours

To accommodate your employees, Beneva will temporarily allow members to maintain their coverage, even if the hours worked are reduced below the minimum number of hours required to be eligible for insurance coverage.

Salary-based benefits, either for life insurance or disability insurance (short and long term), will be paid based on the in-force salary, i.e., the salary used to determine the premium to be paid.

Management of temporary layoffs and eligibility period

For employers governed by the Ontario Employment Standards Act (ESA)

Created for non-unionized employees whose hours of work have been temporarily reduced or eliminated by their employer due to COVID 19, they can now take advantage of the new IDEL and maintain their group insurance plan providing the payment for insurance premiums is still made. Employees may also decide not to maintain their group plan during the leave and stop paying their premiums. In such a case, the employer is required to contact the account manager at Beneva.

Certain conditions apply to this measure:

  • Employees who stopped paying their premiums before May 29, 2020, cannot benefit from their group insurance coverage during the special leave.
  • Employers who stopped making contributions to their benefits plan as of May 29, 2020, are not required to maintain or reinstate that plan during the special leave.
  • Beneva had already allowed for insurance benefits to be maintained on a special basis even if the employer’s policy did not normally provide for this possibility in the event of a temporary layoff. For employers governed by the ESA, Beneva will now allow disability insurance benefits to be maintained until the IDEL has stopped.
  • The employers may maintain full coverage for their employees with a temporarily reduced work scheduleuntil the IDEL has stopped. Subsequently, group administrators will be required to inform Beneva of the reduced salary amounts.
  • The only disease for which special leave due to an infectious disease can be taken, to date, is COVID 19.

We will apply the terms of the temporary layoff clause provided for in your contract. If the continued protection clause of your contract does not meet your needs, we invite you to contact your account manager.

Note that when an insured becomes disabled during a temporary layoff period, the waiting period provided for in the contract begins on the date the employee is recalled to work.

We wish to remind you that it is your responsibility to update your employees’ files for temporarily laid off status (contractual or not). Failing to do so will result in longer claim processing times.

We strongly recommend that you carefully consider the consequences of suspending your group insurance coverage. Should you still wish to temporarily suspend your plan, you may submit the request to your account manager.

If you cannot collect premiums from the employees during the layoff, you can pay the full premium and then get it back when your employees return to work. This will not affect the tax status of the coverage.

The calculation method will be the same as normally used for the contract management.

Employees who have completed their eligibility period during their temporary layoff will be eligible for the insurance plan on day 1 of their rehiring/return to work.

No. Beneva will not accept retroactive layoffs.

Healthcare Claims Management

Virtual paramedical care, an option during the confinement period

In order to continue to meet the needs of their clients who still require their services, some health professionals offer their services virtually. In order to accommodate policyholders who need urgent consultations while waiting for the situation to return to normal, Beneva will agree to reimburse virtual meetings with several professionals to the extent that the type of expense if covered in the contract.

Telephone or videoconferencing consultations should follow the guidelines for each type of health professional. Only certain services are eligible, and pre-recorded sessions are not covered.

  • Career counsellor
  • Dietitian or nutritionist
  • Occupational therapist
  • Special educator
  • Speech-language pathologist
  • Psychologist
  • Psychotherapist
  • Physiotherapist or physical rehabilitation therapist (teleconferencing consultations are not eligible)
  • Sexologist
  • Social worker
  • Couples therapist

Under the Income Tax Act, credits remain valid for a maximum of 24 months. Credits carried over from the past year (12-month duration) can be used for services rendered in the current year. Beneva will not extend the deadline for expiry of the credits.

COVID 19 screening tests are not covered under your group insurance plan. For the time being, COVID 19 diagnostic tests (including rapid tests) are provided for free by provincial healthcare plans and are therefore not eligible under your contract. However, COVID 19 PCR tests are covered under your Health Spending Account with a prescription.

Serological tests are not eligible for reimbursement under your group insurance plan because they are not used to detect the COVID 19 virus itself, but antibodies.

Travel

Beneva provides you with a reference guide to help you better understand your travel insurance coverage with respect to the various risk levels and travel advisories issued by the Government of Canada. Start using this helpful, user-friendly guide today!

Yes, if the illness is severe enough to warrant cancellation. You must provide proof of your medical condition.

  • Completed and signed claim form
  • Proof of the trip’s cancellation from the service provider
  • Copy of all credits and reimbursements already obtained
  • Detailed receipts from your service provider, including their cancellation policy
  • Proof of payment for the trip (credit card or bank account statement)
  • Plane tickets (if applicable)
  • Completed and signed direct deposit reimbursement form (if applicable)
  • Proof of a positive COVID 19 PCR test or rapid antigen test

If your airline cancels your trip, visit its website or contact your travel agent for the procedure to follow.

  1. Call the first payors, i.e., your travel services providers (your travel agency, airline, etc.).
  2. Then contact your travel insurance assistance service. It is provided on the back of your insurance card and in the Client Centre.

 

Your trip must have been purchased between October 21 and December 14, 2021. An advisory to avoid non-essential travel outside Canada must be in effect at the time of departure.

If you were offered a travel credit as compensation, we consider this a reimbursement. We will therefore deduct the travel credit (whether you accepted it or not) from your insurance amount. If the travel credit is equal to your insurance amount, you will not receive any further reimbursement from Beneva.

Then, you must submit a claim form to your travel insurance assistance service.

For those covered by CanAssistance, fill out the form on the CanAssistance site

For Quebec residents who purchased a trip from a travel agency in Quebec

First, submit a reimbursement request directly to the Compensation Fund for Customers of Travel Agents (CFCTA) in the following situations:

Transportation not received Lodging not received Tourist activities not received Main service not received Compromised security Departure or repatriation required Closure or bankruptcy of the travel agency

No. You are not eligible for a refund if you do not meet vaccination requirements, or if you do not meet the PCR / Antigen testing requirements as it is not a cancellation reason listed under your contract terms.

As of October 1, 2020

Yes, you are covered for emergency medical expenses (including those related to COVID 19) for any destination for which a travel advisory notice was issued by the Government of Canada* (Levels 1, 2 and 3).

Your health must be good and stable before departure.

You can also visit https://travel.gc.ca/travelling/advisories to check your destination’s risk level in real time.

La Capitale provides you with a reference guide to help you better understand your travel insurance coverage.

*Travel advisory notice issued by the Government of Canada

  • Level 1 - Exercise normal security precautions
  • Level 2 - Exercise a high degree of caution
  • Level 3 - Avoid non-essential travel
  • Level 4 - Avoid all travel

Note to FNEEQ and AREF members: For destinations with a level 3 travel health notice on the departure date, travel insurance coverage is limited to 30 days.

The following expenses are eligible according to the maximum amount provided for under the contract:

  • Medical expenses
  • Additional expenses incurred for the purchase of a return ticket, or change fees for an existing ticket, according to the following parameters:
    • Single, economy-class ticket
    • Flight operated by a public carrier with a fixed schedule
    • Most direct route to the initially planned destination

Accommodation and living expenses are not covered unless indicated in the contract.

No, the expenses for mandatory COVID 19 screening tests to return to Canada are not covered under travel insurance.

Expenses related to mandatory stopovers in a third country are not covered by your travel insurance plan. This includes costs incurred related to living expenses, accommodation fees, and itinerary change fees.

Expenses related to emergency medical care, including those related to COVID 19 are covered. All other expenses including accommodation and living expense are not covered under your insurance contract.

Call your travel insurance assistance service. You will be referred to a healthcare professional.

This information is provided on your Beneva Insurance card and in your Client Centre.

For those covered by CanAssistance, contact CanAssistance.

During a level 4 warning
You are not covered for emergency medical expenses, including those related to COVID 19. This is valid for all cruises, as long as the Canadian government maintains a level 4 warning, a warning to avoid all travel on a cruise ship.

During a level 3 warning or below
You are covered for emergency medical expenses, including those related to COVID 19. This is valid for all cruises, as long as the Canadian government maintains a level 3 warning and below.

If you want to cancel your cruise, the following conditions must be met:

  • You must have trip cancellation insurance.
  • The cruise must have been booked after March 7, 2022, when the Canadian government lifted its travel advisory to avoid all travel abord cruise ships.

Since October 1, 2020, the following situations apply BEFORE YOUR DEPARTURE if your insurance includes trip cancellation coverage:

If the Government of Canada’s travel health notice for your travel destination changes from Level 1 or 2 at the time of purchase to Level 3* before your departure, then it is possible to cancel your trip. If you decide to travel, you will still be covered for travel assistance (emergency medical expenses including COVID 19) for as long as the Government of Canada’s travel health notice level does not change to Level 4*.

If the Government of Canada’s travel health notice for your travel destination changes from Level 1, 2 or 3 at the time of purchase to Level 4* before your departure, then it is possible and recommended that you cancel your trip. If you do not, you will not be covered for travel assistance.

*The Government of Canada issues 4 travel health notices for travel destinations as follows:

  • Level 1 - Exercise normal security precautions
  • Level 2 - Exercise a high degree of caution
  • Level 3 - Avoid all non-essential travel
  • Level 4 - Avoid all travel

For any trip cancellation prior to departure due to a Government of Canada travel health notice, you must contact Beneva’s travel assistance service for instructions 72 hours before the scheduled departure date.

In addition, if you have purchased your trip through a travel agent and you have to cancel it because of a travel health notice issued by the Government of Canada, you must contact Beneva’s travel assistance service for instructions 72 hours before your deposit becomes payable to your travel agent.

Contact information for your travel insurance assistance service is provided on your Beneva Insurance card and in your Client Centre.

For those covered by CanAssistance, contact CanAssistance.

For Beneva, a travel credit is equivalent to a reimbursement. Therefore, whether you accept the travel credit or not, we will deduct this amount from the reimbursement.

If the travel credit is equal to the total amount, you will not receive any reimbursement from Beneva.

If you do not obtain a full reimbursement or credit for the cancellation of your trip, Beneva will reimburse you for the eligible expenses under your contract.

Additional expenses incurred while awaiting COVID 19 screening test results are not covered (for example, the cost for new plane tickets or changing the return date on the existing ticket, accommodation and living expenses, etc.).

Yes, you can cancel or extend your trip if you are placed under quarantine as long as the quarantine ends 7 days or less before your scheduled departure date or occurs during your trip.

Before incurring any expenses, you must contact your travel insurance assistance service. The contact information is indicated on your Beneva Insurance card and in your Client Centre.

For those covered by CanAssistance, contact CanAssistance.

Yes, you might be. For countries where the federal government has issued a level 1, 2 or 3 travel advisory,* you will be covered for emergency medical care. Unless you have war risk coverage, you will not be covered if the federal government issues a level 4 travel advisory. Please consult your contract for more details and refer to the Government of Canada site to find out the level of travel advisory that applies to the country where you will be travelling.

Please note that the situation is currently very unstable in countries bordering Ukraine and that it may deteriorate suddenly. The federal government’s travel advisory level could change in the coming weeks and accessing emergency medical care or repatriation may be difficult, even unfeasible, in some regions.

*The Government of Canada issues four levels of travel health notices for travel destinations:

  • Level 1 - Exercise normal security precautions
  • Level 2 - Exercise a high degree of caution
  • Level 3 - Avoid all non-essential travel
  • Level 4 - Avoid all travel
  • Detailed receipt including:
    • Name, signature and address of the health care provider
    • Location of service
    • List of services received
    • Cost and date of services received
  • Medical reports
  • Laboratory results (if applicable)
  • Proof of payment
  • Transaction record (if applicable)
  • Claim forms (completed and signed)

Disability Claims Management

Yes, if you have a group insurance plan that includes disability; however, you must meet the requirements under your contract.

On disability and tested positive

If you tested positive for COVID 19 and are disabled (unable to perform the main functions of your job, including if you are working from home), you are eligible for short-term benefits. Beneva will apply the customary waiting period stipulated in your contract.

On disability, but not tested

If you have symptoms, have not been tested for COVID 19 and are disabled (unable to perform the main functions of your job, including if you are working from home), you are eligible for short-term benefits. Beneva will apply the customary waiting period stipulated in your contract.

In preventive quarantine

If you are quarantined as a preventive measure, you are not eligible for short-term disability coverage; in this case you must refer to Employment Insurance.

If you cannot have your physician complete the attending physician statement in the disability claim form, you can fill out the form below.

Beneva will continue to require the initial statement from the employer and employee.

Please note that Beneva reserves the right to request further medical information based on the answers provided in this form (including the result of a PCR test or rapid COVID 19 test).

For forms that are fillable on the computer, employees and employers can print their names and date the forms so Beneva can proceed with the review of disability claims. The print of their name will serve as a signature during this crisis period. If the form isn't fillable on the computer, employees and employers should print it and take a picture or scan it.

If an employee is disabled as a result of a COVID 19 positive diagnosis, he or she becomes eligible for short-term benefits if their group plan includes disability coverage. In this case disability refers to the employee’s inability to perform his or her main job functions, even if working from home.

Beneva will reinstate the waiting period provided for in the contract for all disabilities that begin on November 9, 2020.

Our decision to return to standard claims processing is based on the recent introduction of the Canada Recovery Sickness Benefit (CRSB), which provides financial assistance to employed and self-employed workers unable to work due to COVID 19, as well as our wish to look after the best interests of our policyholders by ensuring the viability of their group insurance plan. Standard processing means applying the same waiting period to all claims, regardless of the diagnosed illness causing the disability.

Yes, if after COVID 19 vaccination complications cause an employee to go on disability leave, in accordance with the disability definition stipulated in the insurance contract, benefits will be paid.

Yes, Beneva will pay the death benefit to the rightful claimant if the death results from a possible complication following COVID 19 vaccination, in accordance with the terms and conditions of the insurance contract.